In vitro activity of tigecycline in combination with various antimicrobials against multidrug resistant Acinetobacter baumannii

Principe, Luigi; D’Arezzo, Silvia; Capone, Alessandro; Petrosillo, Nicola; Visca, Paolo

doi:10.1186/1476-0711-8-18

Cited by 114 publications

(92 citation statements)

References 52 publications

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“…In a study conducted in 2012, it was emphasized that the use of inappropriate antibiotic combination increases CL resistance. 27 Principe et al 7 for the first time reported that they have noticed the synergy between TGC and CL by TK method in one A. baumannii isolate. In two studies conducted by CB method in TGC-CL combination 28 and in TGC-sulbactam, TGC-CL combinations 29 a synergistic effect was observed.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, combined use of antibiotics is recommended to prevent the development of resistance and increase the success in the treatment of MDR A. baumannii infections since. 7,19,20 Recent studies in Turkey found that imipenem-netilmicin, In this study, the interactions of TGC and CL combinations with different antibiotics; AK, CIP, MR, MXF, RF and each other were investigated by CB and TK methods. The best synergistic effect was detected in the CL combinations by CB method, for CL-RF (100%), CL-MR (100%), and in the TGC combinations for TGC-RF (53%).…”

Section: Discussionmentioning

confidence: 99%

“…9 Because, CLSI has not suggested available breakpoints, the United States Food and Drug Administration (2005) susceptibility breakpoints for TGC, and the recommendations of Principe et al 7 for MXF and RF were utilized. By considering MIC values, the isolates were classified into different antibiotype groups.…”

Section: Determination Of Minimum Inhibitory Concentrations and Antibmentioning

confidence: 99%

“…1 Of these alternative classes, polymyxin and tigecycline (TGC) remain the most active treatments in vitro against MDR A. baumannii but resistance against these antibiotics is also reported. 4,6,7,8 Combination therapy is often used in the treatment of MDR A. baumannii infections to prevent the emergence of resistance and obtain a synergistic effect. 1,3,8 The aim of this study was to determine the antimicrobial resistance profile, clonal relation and efficacy of antimicrobial combinations on nosocomial MDR A. baumannii.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Resistance Profiles and Genotypes of Acinetobacter baumannii Isolates and In Vitro Interactions of Various Antibiotics in Combination with Tigecycline and Colistin

Büyük

Yılmaz

Yurtsever

et al. 2017

tjps

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ÖZAmaç: Bu çalışmada nozokomiyal çoklu ilaç dirençli (ÇİD) Acinetobacter baumannii izolatlarının antibiyotik direnç profilinin belirlenmesi, moleküler düzeyde tiplendirmelerinin yapılması ve dirençli izolatlarda antibiyotik kombinasyonlarının aktivitesinin araştırılması amaçlandı. Gereç ve Yöntemler: Seksen dört ÇİD A. baumannii izolatına karşı tigesiklin (TGC), kolistin (CL), amikasin (AK), siprofloksasin (CIP), meropenem (MR), moksifloksasin (MXF) ve rifampisinin (RF) minimum inhibitör konsantrasyon (MİK) değerleri sıvı mikrodilüsyon yöntemi ile belirlendi. Epidemiyolojik ilişki, AP-PZR ve antibiyotiplendirme ile saptandı. Klonal ilişkisiz kökenlere antibiyotik kombinasyonlarının etkinliği dama tahtası (CB) yöntemi ile belirlendi. Dama tahtası yöntemi sonucunda, en etkin gözlenen kombinasyonun etkinliği, seçilmiş bir kökene karşı zamana bağlı öldürme eğrisi (TK) yöntemi ile de araştırıldı. Bulgular: CIP, RF, MXF, MR, AK'nin direnç oranları sırasıyla; %90.47; %47.62; %22.62; %58.33; %50 olarak belirlendi. TGC ve CL direnci görülmedi. Antibiyotik direnç profillerine göre 25 antibiyotip grubu belirlenirken, 15 farklı patern ayırt edildi. Klonal ilişkisiz 15 ÇİD A. baumannii izolatında CB yöntemiyle en iyi sinerjistik etki CL-RF (%100), CL-MR (%100) ve TGC-RF (%53) kombinasyonlarında gözlendi. Seçilmiş bir kökende TK yöntemiyle CL-RF ve CL-MR ile sinerji gözlendi, TGC-RF ile ise aditif etki saptandı. Sonuç: Bu çalışmada her iki sinerji testi de ÇİD A. baumannii izolatlarına karşı CL ile RF kombinasyonunun tedavide iyi bir seçim olacağını işaret etmiştir. Anahtar kelimeler: Acinetobacter, AP-PZR, dama tahtası, zamana bağlı öldürme eğrisi, tigesiklin, kolistin Objectives: The aim of this study was to determine the antibiotic resistance profile, clonal relation and efficacy of antibiotic combinations in nosocomial multidrug resistant (MDR) Acinetobacter baumannii. Materials and Methods: Antibiotic susceptibilities of 84 MDR A. baumannii against tigecycline (TGC), colistin (CL), amikacin (AK), ciprofloxacin (CIP), meropenem (MR), moxifloxacin (MXF), rifampicin (RF) were determined by microdilution method. Clonal relationship was investigated by genotyping using AP-PCR and antibiotyping. Interactions of antibiotic combinations were tested against clonally unrelated strains by the checkerboard (CB) method. The efficacy of the best combinations was also assesed on a selected isolate by the time-kill (TK) method. Results: CIP, RF, MXF, MR, AK resistance was found as 90.47%; 47.62%; 22.62%; 58.33%; 50% respectively; however; CL and TGC were not ascertained. The isolates were distinguished as 25 different antibiotypes and 15 varied molecular patterns. The best synergistic effect was detected in combinations of CL with RF (100%) and MR (100%), in combinations of TGC with RF (53%) against clonally unrelated 15 MDR A. baumannii isolates by the CB method. While CL-RF and CL-MR showed synergy by TK method like CB, on the other hand TGC-RF indicated additive interactions by TK. Conclusion: In this study, both synergy tests showed...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Determination Of Minimum Inhibitory Concentrations and Antibmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antibiotic Resistance Profiles and Genotypes of Acinetobacter baumannii Isolates and In Vitro Interactions of Various Antibiotics in Combination with Tigecycline and Colistin

Büyük

Yılmaz

Yurtsever

et al. 2017

tjps

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“…[1][2][3] Although these studies show better microbiological response with combination therapy, clinical cure and mortality remains unaffected.…”

Section: Introductionmentioning

confidence: 99%

A retrospective observational study of the impact of Tigecycline in treating multidrug resistant pneumonia

Paul

2017

Int J Clin Trials

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Background: Few antimicrobials are currently active to treat extensively drug resistant (XDR) gram-negative bacilli infections. This represents a serious global public health concern. Critically ill patients face the brunt of majority of these infections. Tigecycline has coverage for a majority of these XDR infections (with the exception of Pseudomonas aeruginosa), but is not currently approved for hospital-acquired pneumonia. Nevertheless it is being commonly used for this indication though many meta-analysis have suggested an increased risk of death in patients receiving this antibiotic. Methods: In this retrospective analysis we compared the mortality rates between a Tigecycline based and a non Tigecycline based therapy for XDR infections in the critically ill over a period of 12 months. A total of 93 patients were included in the study.Results: Tigecycline group had significantly increased risk for in hospital mortality with an odds ratio of 6.0 and 95% CI of 1.37 to 26.12 with a p value of 0.01. But such a difference was not evident in 14 day mortality. Conclusions: Initiation of Tigecycline for multidrug resistant, pneumonia needs to be re-thought. Only a small percentage of patients with pneumonia with in-vitro sensitivity having low minimum inhibitory concentration (MIC) would benefit from the drug. Even in this group the risk of increased mortality needs to be carefully considered before Initiation of therapy.

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Antimicrobial combination effects against multidrug‐resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains: A cross‐sectional study

Kazemian,

Karami‐Zarandi,

Heidari

et al. 2024

Health Science Reports

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Background and AimsEmergence of multidrug resistance in non‐fermenting Gram‐negative bacilli is a threat to public health. Combination therapy is a strategy for the treatment of antibiotic‐resistant infections.MethodsIn this cross‐sectional study, a total of 63 nonduplicate clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were collected from various specimens. Identification of bacterial isolates was performed by phenotypic and molecular tests. Antibiotic susceptibility patterns and detection of β‐lactamase genes were determined using the broth microdilution and polymerase chain reaction (PCR) techniques, respectively. Then, the combined effects analysis was determined by the checkerboard method. Based on the status of resistance to carbapenems (imipenem and meropenem), 25 isolates of each genus were selected for further investigation.ResultsFor A. baumannii, blaOXA‐23, blaOXA‐58, and blaOXA‐48 genes were positive in 21 (84%), 17 (68%), and 11 (44%) of isolates, respectively. In P. aeruginosa isolates, blaVIM was the most common gene (44%) and other genes including blaIMP, blaNDM, and blaOXA‐23 were found in nine (36%), six (24%), and three (12%) isolates, respectively. Meropenem (MER)‐tigecycline (TIG) had a significant synergistic effect against 20 (80%) A. baumannii (p value < 0.001). This combination was also efficient against 5 (20%) P. aeruginosa isolates. Moreover, the other combination, tigecycline‐amikacin (TIG‐AMK) was effective against 10 (40%) A. baumannii isolates. The combination of colistin (COL) and MER showed a significant synergistic effect against 21 (84%) A. baumannii (p value < 0.001) and 17 (68%) P. aeruginosa isolates (p value < 0.001).ConclusionThe MER‐TIG and COL‐MER combinations are promising options against resistant bacteria. Our study could be helpful for the development of a new treatment recommendation.

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In vitro activity of tigecycline in combination with various antimicrobials against multidrug resistant Acinetobacter baumannii

Cited by 114 publications

References 52 publications

Antibiotic Resistance Profiles and Genotypes of <i>Acinetobacter baumannii</i> Isolates and <i>In Vitro</i> Interactions of Various Antibiotics in Combination with Tigecycline and Colistin

Antibiotic Resistance Profiles and Genotypes of <i>Acinetobacter baumannii</i> Isolates and <i>In Vitro</i> Interactions of Various Antibiotics in Combination with Tigecycline and Colistin

A retrospective observational study of the impact of Tigecycline in treating multidrug resistant pneumonia

Antimicrobial combination effects against multidrug‐resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains: A cross‐sectional study

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